Basic Information
| Provider Information | |||||||||
| NPI: | 1245891050 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NKWUAKU | ||||||||
| FirstName: | LOUISA | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17606 RAINSBURY AVE | ||||||||
| Address2: | |||||||||
| City: | CARSON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907461518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108198187 | ||||||||
| FaxNumber: | 3108198187 | ||||||||
| Practice Location | |||||||||
| Address1: | 3435 W BALL RD | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928043708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148275880 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2019 | ||||||||
| LastUpdateDate: | 06/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0019X | 19887 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No ID Information.